What is an Anal Fissure?

What is an Anal Fissure?

An anal fissure is a small, superficial tear in the skin located on the outer part of the anus. This condition typically occurs as a result of excessive straining during bowel movements and can cause severe pain. Anal fissures can be seen in both men and women and can affect people of all age groups. Most anal fissures occur at the back part of the anus and can become chronic if not properly treated. Fissures are generally treatable conditions and may require various medical treatments and, in some cases, surgical intervention. Anal fissures usually present themselves with traces of blood on toilet paper and pain during the use of the toilet.

What Causes Anal Fissures?

The most common cause of anal fissures is excessive straining during hard bowel movements or chronic constipation. This situation leads to micro-tears in the anal region, and over time, these tears can turn into larger fissures. Additionally, conditions such as diarrhea and chronic inflammatory bowel diseases can also contribute to the formation of anal fissures. Pregnancy and the childbirth process can also increase the risk of anal fissures in women. These conditions can increase pressure on the anal canal, causing the tissue to tear. Activities that apply mechanical trauma to the anal canal, such as anal sex, can also lead to the formation of anal fissures.

What are the Symptoms of Anal Fissures?

The most pronounced symptom of anal fissures is severe pain during defecation. This pain can continue after bowel movements and is often described as a burning sensation. Bleeding from the anus during and after bowel movements is also a common symptom; this usually appears as bright red blood traces on toilet paper. In some cases, itching or a burning sensation in the anal area may also be experienced. In chronic fissures, a skin tag or a small bump described as the outer end of the fissure may form on the outer part of the anus. These symptoms can significantly affect the quality of life and impede affected individuals from comfortably performing their daily activities. Therefore, it is important to seek medical advice when symptoms are noticed.

How is an Anal Fissure Diagnosed?

The diagnosis of anal fissures can be made based on the presence of typical symptoms and physical examination findings. Patients typically experience specific symptoms such as severe pain during and after defecation, bleeding, and burning. These symptoms are evaluated by taking a detailed medical history when a health professional is consulted. The patient’s history, the duration and severity of symptoms, and bowel habits provide important clues for the diagnosis of anal fissures. If the patient suffers from other health conditions such as constipation that may contribute to fissure formation, these conditions are also assessed. During the diagnostic process, a careful evaluation is made to exclude other possible underlying causes of the symptoms.

How is an Anal Fissure Examination Conducted?

Physical examination is a fundamental method in diagnosing anal fissures. The examination usually begins with a visual inspection of the anus and surrounding area. The doctor carefully examines the anal region to determine the presence, location, and size of the fissure. Fissures are mostly localized at the back part of the anus and can cause pain during the examination. Therefore, the comfort of the patient is prioritized during the examination. If deemed necessary, additional tests such as anoscopy can be performed for a more detailed evaluation. Anoscopy involves the use of a tube-like instrument to better visualize the inside of the anal canal. This procedure allows the doctor to thoroughly examine the inside of the anal canal and possible internal hemorrhoids or other abnormalities. Such examinations are critical in confirming the diagnosis of fissure and determining the treatment plan.

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